Corporate Appeals Analyst - RN

Are you an experienced Corporate Appeals Analyst - RN with a desire to excel? If so, then Talent Software Services may have the job for you! Our client is seeking an experienced Corporate Appeals Analyst - RN to work at their company in Columbia, SC.

Must-have qualifications:

• 3 years of clinical experience; or 2 years of clinical experience plus 1 year of utilization/medical review, quality assurance, or home health experience
• Associate Degree in Nursing or graduate of an accredited School of Nursing
• Active, unrestricted RN license in the state of hire or active compact multistate unrestricted RN license as defined by the Nurse Licensure Compact (NLC)
• Healthcare insurance experience preferred
• Day-to-day work will focus heavily on reviewing medical records and provider appeals/denials, confirming appropriate coding, and determining whether a denial should be upheld or overturned.
• Please ensure candidates are genuinely interested in an appeals/clinical review role and understand this is not a traditional bedside RN position before submitting.
• Please confirm the candidate meets the required RN licensure and experience requirements listed above before submission.
• Manager is specifically looking for candidates who demonstrate dependability and accountability.